feedback icon

Fri May 25, 2018 - 21 weeks ago

Login or Register to vew

3 Views, 0 Applications

Regional Provider Networks Director - Medicaid - Work Remotely -

Regional Provider Networks Director - Medicaid - Work Remotely - PS7305


**Location:** **United States**

**Field:** Provider Network Management

**Requisition #:** PS7305

**Post Date:** 5 hours ago

_Your Talent. Our Vision._ **At Anthem, Inc.,** it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will **drive the future of health care** .

This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.

**Regional Provider Network Director - Medicaid - Work Remotely - PS7305**

**Work Location:** This position allows for working remotely / work from home.

This position is responsible for providing strategic leadership to all Medicaid Health Plan Presidents around all things impacting their provider networks including but not limited to: provider engagement, service, experience, network access/availability oversight, strategic / tactical planning for provider networks, provider collaboration/engagement, network optimization and value based payment strategies, network performance and contracting for a Medicaid region.

Additionally will work with Enterprise Provider Solutions team to annually set and track performance against scorecards and its Medicaid service level agreement.

Primary duties may include but are not limited to:

+ Provides execution direction and monitors cost of care strategies related to provider networks for regional Medicaid markets and products.

+ Develop scorecard measures, drives enterprise review / adoption and tracking of performance.

+ Delivers competitive cost of care trends in assigned region.

+ Develops plan specific provider network strategy (optimization, engagement CoC, service, adequacy) for each Medicaid health plan in the region; in alignment with the overall Medicaid BU and corporate priorities.

+ Aligns contracting strategy with medical management strategy.

+ May also be responsible for contractual compliance with government regulations.

+ Integrates quality metrics and incentives into contracting process.

+ Ensures compliance with regulatory and accreditation standards.

+ Requires BS/BA in healthcare operations or network development experience; or any combination of education and experience which would provide an equivalent background.

+ MBA preferred.

+ Provider Relations experience very strongly preferred.

**_Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran._**